The usefulness of telemedicine devices in patients with severe heart failure with an implanted cardiac resynchronization therapy system during two years of observation

Abstract

Background: Heart failure (HF) remains a disease with a poor prognosis. Telemonitoring is a medical service aimed at remote monitoring of patients. Aim: The study aimed to identify the clinical relevance of non-invasive telemonitoring devices in HF patients. Methods: Sixty patients aged 66.1 (11) years, with left ventricular ejection fraction (LVEF) 26.3 (6.8)% underwent cardiac resynchronization therapy (CRT) implantation. They were randomly allocated to the control (standard medical care) or study (standard medical care + telemonitoring device) groups. During the follow-up (24 months), the patients in the study group provided body mass and blood pressure, along with electrocardiogram on a daily basis. The data were transferred to the monitoring center and consulted with a cardiologist. Transthoracic echocardiography and a 6-minute walk test were performed before and 24 months after CRT implantation. Results: During the two-year observation, the composite endpoint (death or HF hospitalization) occurred in 21 patients, more often in the control group (46.8% vs. 21.4%; P = 0.026). In univariate analysis: the use of telemetry (hazard ratio [HR], 0.2; 95% confidence interval [CI], 0.07–0.7; P = 0.004), the presence of coronary heart disease (HR, 41.4; 95% CI, 3.1–567.7; P = 0.005), hypertension (HR, 0.24; 95% CI, 0.07–0.90; P = 0.035), and patient’s body mass (HR, 0.36; 95% CI, 0.14–0.92; P = 0.03) were related to the occurrence of the composite endpoint. Conclusions: The use of a telemonitoring device in CRT recipients improved the prognosis in 2-year observation and contributed to the reduction of HF hospitalization.